Patient’s Name: Mr. Brennan
Patient’s Age: 82-years-old
Admission Date: 06/20/2019
Admitted From: Putnam Hospital Center
Discharge Date: 07/25/2019
Discharge To: Home
Length of Stay: 50 days
Reason for Stay: Mr. Brennan needed skilled Physical Therapy (PT) and Occupational Therapy (OT) to improve his strength and functional ability following a recent hospital stay for multiple infections.
How did this patient hear about The Paramount at Somers? The patient was here before.
Details of Experience:
Mr. Hugh Brennan is an 82-year-old male who was hospitalized due to increased confusion, poor appetite, UTI, with a history of strokes, spinal stenosis, high blood pressure, hypertension, elevated cholesterol, and multiple falls at home. Patient transition to the Paramount at Somers for skilled services and increased safety interventions to reduce falls and to increase stability and independence with ADLs with goals of safely transitioning home.
Upon entry into the community, the patient was greeted and met by the Paramount staff and immediately assessed and made comfortable. The community worked hard to develop a plan of action to support Mr. Brennan’s goals of returning home independently back to his wife.
Prior Level of Functioning: Hugh lives at home with his spouse and was independent in all ADL’s, he was walking independently without any assistive devices and was able to negotiate stairs inside and outside of his home.
Upon Physical Therapy (PT) and Occupational Therapy (OT) evaluations, his levels were assessed at minimum assistance for transfers and bed mobility and walking 10 feet with a rolling walker. For OT, he required setup for grooming and upper body dressing, Moderate assistance for bathing and lower body dressing and minimum assistance with toileting and toilet transfers.
Week 1
6/7 – 6/13/19
In PT, Hugh worked on a variety of leg exercises, task performance training and sit to stand/ stand to sitting activities. In addition, he worked on improving his gait pattern, weight shifting and balance exercises and posture awareness and alignment training. His sit to stand transfer status improved from minimum to contact guard assistance. His walking progressed from minimum assistance at 10’ to contact guard assistance at 25’. With OT, Hugh performed upper body exercises, he received resistance training and worked on balance and coordination. During this time, he continued to make progress in toileting and toileting transfers from moderate to contact guard assistance and lower body dressing improved from moderate assistance to minimum assistance.
Week 2
6/14 – 6/20/19
In PT, Hugh continued working on leg exercises, task performance training and sit to stand/ stand to sitting exercises. He continued working on improving his gait pattern, weight shifting and balance exercises and posture and alignment. His sit to stand transfer status improved from contact guard assistance to stand by assistance. His walking progressed from 25’ to 50’ with contact guard assistance. In OT, Hugh had difficulty with functional activity endurance. Will continued with a variety of exercises to address endurance, balance, safety awareness, and strength. Hugh improved in his toileting and toileting transfers progressing from contact guard to stand by assistance. Also, he improved in lower body dressing from minimum assistance to contact guard assistance.
Week 3
6/21 – 6/27/19
With PT, he continued working on exercises to improve his gait, weight shifting, posture, and balance. His sit to stand transfer status improved from contact guard to stand by assistance. He had no improvement in his walking distance at 50’ with contact guard assistance. Also, during this week, he started to train on stair climbing and was able to perform 2 out of 13 stairs with minimum assistance provided. In OT, he continued to work on standing unsupported balance for optimal safety and independence. He continued to have issues with his endurance requiring frequent rest breaks and reliance on his walker for balance. Despite these challenges, he was able to improve his ability to perform lower body dressing progressing from contact guard to stand by assistance.
Week 4
6/28 – 7/4/19
In PT, Hugh continued working on leg exercises, task performance, sitting to standing and standing to sitting exercises. He continued working on gait pattern, weight shifting, balance, posture, and alignment. His sit to stand transfers status improved from standby to supervision assistance. His walking progressed from 50’ to 90’ with contact guard assistance. With stair exercises, he was able to perform 2 out of 13 stairs progressing from minimum assistance to contact guard. In OT, he started training walking with a rolling walker to the in the bathroom to simulate his home environment. He continued to work on standing unsupported balance for optimal safety and independence. He continues to have issues with his endurance requiring rest breaks after toileting. He is provided education on energy consumption techniques for grooming and ADL’s. This week he was able to improve in his toileting, toileting transfers and lower body dressing from stand by assistance to supervision assistance.
Week 5
7/5 – 7/10/19
Hugh continued to work on his weekly PT exercises. His sit to stand transfers status remained at supervision assistance and his walking progressed from 90’ with a rolling walker with contact guard to 100’ with stand by assistance. His stair performance had improved from 2 steps minimum assistance to 4 steps with contact guard assistance. In OT, he showed much improvement from the previous weeks with endurance, strength, balance and safety awareness. He continued with exercises to improve his independence in self-care tasks. This week he was able to improve in his toileting, toileting transfers and lower body dressing from stand by assistance to supervision assistance. He was provided additional training on walker use in the bathroom.
Week 6
7/11 – 7/17/19
Hugh continued to work on his weekly PT exercises. His sit to stand transfers status improved from supervision to set up assistance. His walking progressed from 100’ with rolling walker with stand-by to 150’ with supervision assistance. His stair performance improved from 4 steps with contact guard to 8 steps with stand by assistance. In OT, he made great progress with the rolling walker for all mobility and ADL tasks, safety awareness and balance.
Week 7
7/18 – 7/24/19
In his final week of PTHugh continued to work on his weekly exercises. His sit to stand transfer status improved from set up to modified independence assistance. His walking progressed from 150’ with rolling walker with supervision to 250’ with set-up assistance. His stair performance improved from 8 steps with stand-by to 13 steps with supervision assistance. In OT, Hugh has progressed to perform all dressing, toileting and grooming tasks at modified independent status.
In conclusion, Hugh had some difficult health setbacks which took away his strength and his ability to perform functional tasks, walk and care for himself. This therapy was a long and slow process for him, especially since it took him a long time to regain his stamina. Regardless of his setbacks and difficulties, he remained focused and determined to return to his previous level of functioning and that’s exactly what happened when he was able to return home to his spouse and independent life. It is at the core of The Paramount mission to provide and foster unprecedented levels of Rehabilitation and Nursing needs to our patients. All made possible by our caring and committed team at The Paramount to get our patients back to their fullest potential.